Observations as a Clinical Evaluation Method in Nursing Education 24/11/2010

Observations as a Clinical Evaluation
Method in Nursing Education
Dr. Belal Hijji, RN, PhD
Learning Outcomes
At the end of this presentation, participants will be able to:
• Discuss the value of observation in clinical evaluation.
• Identify some of the threats to the reliability of
• Describe how to use anecdotal notes as a method of
recording observations about student’s performance.
“For as long as people have been interested in studying the
social and natural world around them, observation has
served as the bedrock source of human knowledge”.
(Adler and Adler, 1994, p. 377)
Observing students is a main strategy for evaluating
performance in clinical practice, simulation, and learning
(Oermann and Gaberson, 2010)
Threats to Validity and Reliability of
• Observations of students may be influenced by the teacher’s
values, attitudes, and biases.
• Different teachers may focus attention on different aspects of
performance. For example, during an IV medication
administration, a teacher may focus mainly on the technique
used for its administration, while another may focus on asking
questions about the purpose of the medication, and observing
how the student interacts with the patient.
• Incorrect judgments could be made about student’s
performance, such as inferring that a student is inattentive
during conference when in fact s(h)e is thinking about the
comments made by others.
• The level of student’s performance may vary between
observations. This also applies to teachers and nurses.
• All observed behaviors should be shared with the students.
Recording Observations
• Recording observations of students in clinical settings,
simulation, and learning laboratories could be carried out
through anecdotal notes, checklists, and rating scales.
Anecdotal notes will be the focus of this presentation.
• Regardless of the method being used, educators should record
objective NOT subjective data. For example, if our intention is
evaluate a student’s performance on “establishing a sterile
field”, variables such as the following cannot be included:
• Professional development, communication skills, and
on a scale of 1 2
Anecdotal Notes
• Teachers may not remember the observations made of each
student for each clinical activity. Anecdotal notes are helpful in
remembering what they observed and the context in which the
performance occurred.
• The elements of effective anecdotal notes are presented below.
Figure 1. Key elements of effective anecdotal notes
• Anecdotal notes are narrative descriptions of observations
made about student’s performance.
Figure 2. Poorly written anecdotal note
Figure 3. Well-written anecdotal note
• Anecdotal notes should be recorded as close to the time of the
observation as possible.
• Anecdotal notes should be shared with students as frequently
as possible; otherwise they are not effective for feedback.
• Oermann, M. & Gaberson, K. (2008). Evaluation and Testing in
Nursing Education. 3rd edition. New York: Springer.
• Adler, P. and Adler, P. (1994). Observational techniques. In N.
Denzin and Y. Lincoln (eds.) Handbook of Qualitative Research.
London: Sage. pp. 377-392.
Thank You Very Much
Any Questions?